Chapter 82: The Autopsy Mystery
With Zhang Xiaodong's approval, Xu Jingnan immediately conducted an autopsy on Zhang Yuan's body with the cooperation of the hospital. You must know that this is a plan set by Li Yiting and Yege to kill two birds with one stone, which can not only obtain sufficient evidence, let the truth of the deceased's death be revealed, but also relieve at least half of the crisis in the hospital, because poor Zhang Yuan has been placed at the elevator door on the first floor of the outpatient building after his death, not allowing anyone to enter or exit, if there is decay after a long time, it will not only make everyone in the hospital feel uncomfortable, but also completely destroy this clue.
In fact, before the autopsy, Li Yiting and the others had a premonition that since Zhang Yuan's examination and treatment were the same as Zheng Jun and Guo Ke, they still needed a detailed examination, which was not only necessary for meticulous science, but also for the needs of the case. Because Guo Ke did not receive an autopsy back then, it was too old to be investigated, and although Zheng Jun was personally investigated by Beiting, he also placed it in the morgue for a long time. More importantly, Zheng Jun was damaged by gas poisoning before the onset of the disease, and his body was already a little sick, so he could not fully explain the problem, but today's Zhang Yuan is different, he is young, except for excessive study pressure and a little insomnia, there is no organic disease, and his death process is more valuable for reference.
According to the patient's case report before his death, Zhang Yuan was found to be the most malignant pancreatic cancer, so Xu Jingnan focused on the position of the left abdomen, where in addition to the pancreas, there are liver and gallbladder, and not far below is the kidney, the organs are relatively dense, and the dissection is more difficult. In the last operation, the hospital removed part of Zhang Yuan's pancreas and dissected the nearby lymph nodes, and the operation was successful, and there was no problem with nearby metastases at that time.
Under Xu Jingnan's autopsy, he also confirmed that Zhang Yuan did have pancreatic cancer, and the pancreas that was left to remain at the time of his death had also been invaded by the tumor. In addition, to Xu Jingnan's surprise, the deceased Zhang Yuan's gallbladder also had a tumor, and the peritoneum was even wrapped, that is, his pancreatic cancer metastasized immediately after the operation, which induced peritoneal cancer with a very high mortality rate. In the end, it was determined that the cause of Zhang Yuan's death was the blockage of the bile ducts caused by cancer metastasis, and the pancreas had completely lost its function.
After the autopsy was completed, Li Yiting also invited Jiang Tao, director of the oncology department, and Lin Jia, Zhang Yuan's attending doctor, to have a consultation to discuss the medical record.
Lin Jia, who is Chinese New Year's Eve years old today, is an outstanding model among the young doctors of the Sixth Hospital, and after Xiang Wen's accident, he became the focus of the oncology department. After graduating with a master's degree, he worked as a resident doctor for three years, and then worked in the oncology department for less than two years. Despite his relative inexperience, he is very calm and reliable, with zero surgical mortality and a below-average recurrence rate in the past.
After Zhang Yuan returned to the hospital for the second time and confirmed that it was cancer, no doctor was willing to take in the patient due to the painful experience in the past, and finally Lin Jia, as the youngest doctor, became Zhang Yuan's attending doctor. Zhang Yuan's operation did not break his record of zero mortality, but soon after the operation, Lin Jia, who was in charge of paying attention to the patient every day, had already noticed that something was wrong with Zhang Yuan, so he planned to investigate in detail, but the family did not cooperate, which made Lin Jia get in the way and had to give up.
Beiting now understands that Zhang Yuan's family, in fact, is the uncle Zhang Xiaodong, who is reluctant to spend more money, and they also sigh that they are not their own flesh and blood, and at the moment of life and death, they are still thinking about money.
Lin Jia was indeed a little helpless, after Zhang Yuan's death, he was escorted home and ordered not to show up. Xiang Wen is clear about what he has done, so naturally he will not be stupid and cause trouble, but for Zhang Yuan, he is also sorry, after seeing the autopsy report, he said helplessly, "Hey! In fact, when I found out that something was wrong with him, even if the family was willing to spend money to check it, it might be too late, you have also seen it, he has transferred so badly, and it is no longer meaningful to go for treatment at that time, it will only delay for a few more days at most, and it will cost a lot, and it is estimated that the family will not accept it!"
Xu Jingnan nodded, "Doctor Lin is right, the peritoneum metastasizes so quickly, and under the current medical standards, even in a big hospital, it is powerless, but Doctor Lin, did you not find other metastasis problems during the operation?"
Lin Jia categorically denied it, "It is true that no, although the patient did not undergo expensive PET-CT examination, but after the laparotomy, we can see his pancreas, gallbladder and liver with the naked eye, except for the removal of the pancreatic duct, there is no problem in other parts, which is different from the problem mentioned in your current autopsy." ”
Looking through the treatment log, Zhang Yuan's operation to death took less than two weeks, which puzzled everyone present, and the experienced director Jiang Tao was even more unbelievable, "I have been doing it for more than 20 years, and I have never seen a patient's tumor develop so fast, there is no problem during the operation, and the abdomen will be full after more than ten days, how is this possible?"
Xu Jingnan fell into silence, if Lin Jia didn't lie, of course he wouldn't lie because there must be a film reference before the operation, then the other metastatic tumors in Zhang Yuan's body could only develop after the operation, such a speed, from a scientific point of view, there are actually two factors that can be slightly explained. One is that the patient Zhang Yuan is very young, for cancer cells, the younger and better the body, the faster the growth, because these cells need a lot of nutrients to proliferate, and the young and vigorous body just meets such needs;
But these are just suspicions and speculations, because the family refused to give Zhang Yuan further examination at that time, resulting from the beginning of the operation to the patient's death, there was no evidence left to check, and only relied on the oral statements and speculations of the parties, which is indeed not rigorous enough, and there is also the possibility of deliberate fraud, Xu Jingnan cannot draw conclusions. Therefore, he decided to perform pathological analysis of the tumor tissue cut from Zhang Yuan's body, which was the only evidence left, but it would take a long time to wait.